Hyderabad: At a time when antimicrobial resistance (AMR) is emerging as a major public health concern, nearly three out of four children visiting outpatient departments (OPDs) are being prescribed antibiotics, according to a recent study, which also found extremely low use of generic medicines.The study, conducted by researchers at Care College of Pharmacy under Kakatiya University, found that children were more frequently prescribed antibiotics from the World Health Organization’s (WHO) ‘Watch’ category than from the recommended ‘Access’ category. The WHO introduced the AWaRe (Access, Watch, Reserve) classification in 2017 to promote the rational use of antibiotics and curb AMR.The researchers also found that only 2.4% of prescriptions were written using generic drug names, with branded medicines accounting for the overwhelming majority.“As many as 76.1% of prescriptions contained at least one antibiotic. Azithromycin was the most frequently prescribed antibiotic, with an average of about one antibiotic prescribed per prescription,” said Satyanarayana SV Padi, head of the department of pharmacy practice.The study was conducted at a private hospital in Warangal. Researchers analysed 891 paediatric outpatient encounters, of which 65.8% involved males and 34.2% females. Infants accounted for the largest share of patients (38.1%), followed by children in the early childhood age group (29%).Of the 678 antibiotic prescriptions analysed, 96.9% contained a single antibiotic, while 3.1% contained two antibiotics. Upper respiratory tract infections (49.6%) were the most common diagnosis among the children studied.Azithromycin (20.9%) was the most commonly prescribed antibiotic, followed by Cefpodoxime (18.2%).Published in the Journal of Pharmaceutical Research International, the study observed that ‘Watch’ category antibiotics accounted for 72.4% of prescriptions, compared with 26.9% for ‘Access’ category antibiotics. ‘Reserve’ antibiotics were prescribed least frequently, accounting for just 0.7%.“The implementation of the WHO AWaRe framework encourages responsible and rational antibiotic use and helps monitor antimicrobial consumption to effectively tackle AMR. As per the framework, Access category antibiotics should be preferred over Watch category drugs. However, in practice, doctors continue to prescribe more Watch category antibiotics and branded drugs,” Padi added.
